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One of President-elect Trump’s many campaign promises included “repealing and replacing” the Affordable Care Act (ACA), known as Obamacare. Trump nominated Rep. Tom Price, M.D. (R-Ga.) to serve as the Secretary for the Department of Health & Human Services. Trump’s selection of Price signals that Trump is pushing forward with his promise to aggressively repeal and replace the ACA. If confirmed, Price will lead 11 agencies, including the FDA and the National Institutes of Health, with a $1-trillion budget and the ultimate oversight responsibility for both Medicare and Medicaid.

Who is Tom Price?

Before entering politics, Price worked in private practice as an orthopedic surgeon for nearly two decades and as an assistant professor at the Emory University School of Medicine. Price served four terms in the Georgia State Senate, before his election in 2004 to represent Georgia’s 6th District. Price, who is the current chair of the House Budget Committee (where he succeeded Paul Ryan), also served on the health subcommittee of the House Ways and Means Committee during his tenure.

Why was he nominated?

Price established himself as a prominent Republican on healthcare policy. According to GovTrack.com, the vast majority of bills sponsored by Price (49 percent) involved healthcare. In 2014, Price authored the Empowering Patients First Act, which was one of the first foundational plans from which the House Republicans formed their unified healthcare plan. Some anticipate that Price and other Republicans will use the unified healthcare plan as an initial blueprint for replacing the ACA.

Healthcare policies proposed by Price include:

Tax credits to offset the cost of individual health coverage

Expanded Health Savings Accounts

The sale of health insurance across state lines

Individual tax credits based on age, not income

Allowing those on government-sponsored health plans (e.g., Medicare and Medicaid) to receive a tax credit for opting out and purchasing a different plan

Creation of state-level, high-risk pools for those with pre-existing conditions

Price also introduced bills to reverse various payment reforms that were perceived as uniquely adverse to healthcare providers. And, Price criticized some aspects of the Medicare Access and CHIP Reauthorization Act (MACRA), where he expressed concerns that some of the new regulatory requirements implementing value-based initiatives could infringe on the patient-physician relationship.

The American Hospital Association, American Medical Association, America’s Essential Hospitals, Association of Academic Medical Colleges and American’s Health Insurance Plans have all issued statements supporting the nomination of Tom Price and promising to work with the new administration.

What is next?

Once the President-elect and/or President submits the name of its nominee for a cabinet-level position, the Senate Committees of jurisdiction do a background investigation on the nominee. For the HHS Secretary, the relevant committees of jurisdiction are the Senate Finance and/or Senate Health Education Labor and Pensions Committee.

After the appropriate investigation, the committee or committees of jurisdiction conduct a nomination hearing. At this hearing, the nominee, as well as different stakeholders, have the opportunity to testify. Thereafter, the Committee advances the individual’s nomination by a majority vote and forwards the nomination to the full Senate body for approval.

The Senate conducts a floor debate on the nomination and ultimately takes a final vote as to whether or not to confirm the nominee by a majority vote on the Senate floor. It is important to note that under the current Senate rules, cabinet-level nominations are not subject to filibuster and thus 60 votes are not needed to end debate. Only a simple majority is needed to confirm the nomination on the Senate floor.